Fracture Prevention Service punches high
A Southern health service designed to help older adults in Otago and Southland stay independent and out of hospital from falls and fractures is punching above its weight nationally.
The publicly-funded Southern Fracture Liaison Service (FLS), delivered by local primary health organisation (PHO) WellSouth, works with people aged 50 plus who have had a fragility fracture to help them regain strength and avoid further falls, which lead to a sharp decline in health.
Looking back across the last three years in the recently released Australia New Zealand Fragility Fracture Registry Annual Report, the Southern FLS supported 553 patients in Otago and Southland in 2022-2023. In the 2024-2025 financial year, that number reached 881, a 59% increase over three years. Nationally, this places the Southern FLS well above the national average of +27%, and third highest across New Zealand Aotearoa, after Mid Central (+159%) and West Coast (+73%).
Last year, the Southern service also achieved Gold status through the International Osteoporosis Foundation's Capture the Fracture® programme, the highest international benchmark for fracture prevention care.
Dr Richard Macharg, Clinical Lead of the Southern FLS, says the service is designed to interrupt a chain of decline after the very first fracture.
“Fractures, even those that seem small, can be the warning signs of more serious consequences,” he says.
“When identified and managed appropriately, osteoporosis and falls risk can be addressed and we can then help avert the pain, long-term disability and potentially life-threatening consequences of a major fracture."
For many older people, a fragility fracture is the start of a rapid decline. Approximately 50% of all people with hip fractures have had a previous fracture. A hip fracture often means surgery, prolonged hospitalisation, and for many people a permanent loss of independence, for example moving out of the family home, relying on others, thereby withdrawing from community life. As a result, mortality risk increases.
Worldwide, one in three women and one in five men aged 50 and over will suffer a fragility fracture as a result of osteoporosis. Read a local example below.
The report also shows that the Southern service stands out nationally for its Strength and Balance referral and engagement rates, one of the strongest performances across all 22 FLS areas in New Zealand. The Falls and Fracture Prevention team at WellSouth supports patients, engages them with community Strength and Balance classes and, when necessary, provides in-home exercise programmes to reduce falls risk and help older people stay strong and independent.
In the South, the service's reach continues to grow. The team recently secured access to public hospital radiology reporting data — a three-year advocacy effort — enabling identification of vertebral fragility fractures that would previously have gone unmanaged.
Modelling by Osteoporosis New Zealand predicts that over the next three years, the Southern FLS could reduce up to 1,200 bed days in Dunedin and Southland hospitals combined — capacity freed at a time when the New Dunedin Hospital is being built and the population is ageing.
Dr Macharg also chairs Te Waipounamu Falls and Fragility Fracture Prevention Coalition, the first coalition of its kind in New Zealand, bringing together health, community, and sector partners across Te Waipounamu to extend prevention upstream.
"Te Waipounamu is a leader in reducing falls and preventing injuries before they occur through a coordinated, people-centred prevention approach. We focus on equity, functional independence, and delivering the right care to the right person, at the right place and time,” says Dr Macharg.
You can read about the ANZFFR in the 2026 ANZFFR Annual Report is available at www.fragilityfracture.co.nz/publications
Case study: A Dunedin family and why fracture risk runs across generations
The 2026 ANZFFR Annual Report features the story of Dunedin mother Marilyn Chettleburgh, 79, and her daughter Linda Dingley, 58 — both now patients of the Southern FLS. Marilyn had lived with an osteoporosis diagnosis for 15 years before fracturing a bone in her neck, then her pelvis. After her second fracture she was identified and supported by the WellSouth Fracture Liaison Service. It was during a routine follow-up phone call that Linda happened to mention she had also recently broken her wrist walking her dog, an injury that had been slow to heal but had not prompted anyone to question why. She was referred for a DXA scan, which confirmed she also had osteoporosis.
"I knew Mum and my aunty had it, but I never thought it would happen to me," Linda says.
"If I'd known that having a family history put me in a higher-risk category, I might have taken more precautions."
Both women are now actively managing their bone health. Their story is a reminder that fracture risk does not stop with one person — and that a well-timed call from a trained FLS coordinator can change the trajectory of a whole family.
About the Southern Fracture Liaison Service
The Southern Fracture Liaison Service is delivered by WellSouth Primary Health Network across Otago and Southland. It identifies people aged 50 and older who have sustained a fragility fracture, assesses their bone health and falls risk, and coordinates a care plan to prevent further fractures. Established in 2015 and funded by ACC with support from Osteoporosis New Zealand, the service holds International Osteoporosis Foundation Gold service provider status.